Delaware County Circuit Court ADR Project Date: ‘Delaware County Court Administration 100 W. Washington Street Cause # 165-747-7734 Fax-765-281-9462_ | | Muncie, Indiana 47308 | Delaware County Circuit Court Alternative Dispute Resolution (ADR) Project Facilitation Agreement understand that | am participating in facilitation concerning the following parties and/or minor children: Tunderstand that 1, Information shared in a facilitation session is confidential, with the exception of information related to any criminal activity, including but not limited to, information regarding child abuse or neglect and/or an intent to cause immediate or future physical harm to another person. Such information will be reported by one or more of the professionals participating in the facilitation. 2. have the right to be assisted by independent legal counsel if| 30 choose, 3. agitators and staff who are working for the DELAWARE COUNTY CIRCUIT COURT ADR PROJECT are serving as neutral third party facilitators, and will not impose an agreement or judgment on anyone, offer legal advice to any party, nor provide a recommendation to any party or to the Court. 4. The only record of the facilitation session that the facilitator or project administrator will present to the Court will be a copy of the signed facilitation agreement, a notice of non-appearance or continuance, a notice and reason why the case must be referred back to the Court, or a notice that no agreement was reached. 5. understand that by participating in facilitation of this case I do not give up any of my rights to due process under the law and that | may choose not to sign an agreement. 6. __Aftera faclitation agreement is signed and submitted to the Court, the Court may enter an order, with or without a hearing, accepting or rejecting the agreement. Alternatively, the Court may request modification of the terms of the agreement with the consent of all participants, 7. Allfaclitated agreements are voluntary and consensual. No one is forced to accept terms he or she does not like in a faciitation meeting. I the participants reach an agreement in facilitation, it is binding only if itis accepted by the Court. | agree that: 8. | will make a good faith effort to work to try to resolve the issues for which this case was referred to facilitation. 9. | will maintain confidentiality and will not share what is said in facilitation with others outside of the child protective process, except as outlined in paragraph #1 above. 10. | will not involve the facilitators, the staff, or the records of DELAWARE COUNTY CIRCUIT COURT ADR PROJECT in any Court proceeding, by subpoena or other means. 14, Ifa facilitation agreement is reached, | will fulfil the terms of the settlement. Name (Print): Signature: Date: Relationship to child(ren) and/or case: ‘Attorney: (if applicable) Date: Administrator: Date: Facilitator: Date: